54 articles - From Friday May 27 2022 to Friday Jun 03 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Clin J Am Soc Nephrol |
Evaluation of Conflicts of Interest among Participants of the Japanese Nephrology Clinical Practice Guideline. Most of the Japanese CKD guideline recommendations were on the basis of low quality of evidence by the guideline authors tied with pharmaceutical companies, suggesting the need for better financial conflicts of interest management. |
meta-analyses and systematic reviews
RCT, clinical trials, retrospective studies, etc…
| Am J Kidney Dis |
Initiation Dose of Allopurinol and the Risk of Severe Cutaneous Reactions in Older Adults With CKD: A Population-Based Cohort Study. We examined the risk of severe cutaneous reactions in older adults with CKD who were newly prescribed allopurinol at varied doses. Design Population-based cohort study using linked healthcare databases. Setting and participants Patients in Ontario, Canada (2008-2019) aged >66 years, with an eGFR 100 mg/d versus =100 mg/d were twice as likely to visit a hospital with a severe cutaneous reaction in the next 180 days. |
| Clin J Am Soc Nephrol |
Association of HLA Mismatches and Histology Suggestive of Antibody-Mediated Injury in Absence of Donor-Specific Anti-HLA Antibodies. The histology of antibody-mediated rejection and its defining lesions are also observed in patients without circulating anti-HLA antibodies and relate to the degree of HLA mismatch. |
Moving from Evidence to Implementation of Breakthrough Therapies for Diabetic Kidney Disease. Finally, it is imperative that patient preferences and priorities shape implementation strategies. Access to care and implementation of breakthrough therapies for DKD can save millions of lives by preventing kidney failure, cardiovascular events, and premature death. Coalitions comprised of patients, families and community groups, healthcare professionals, healthcare systems, federal agencies and payers are essential to develop collaborative models that successfully address this major public health challenge. |
Variation in Peritoneal Dialysis Time on Therapy by Country: Results from the Peritoneal Dialysis Outcomes and Practice Patterns Study. Countries in the PDOPPS with higher rates of kidney transplantation tended to have shorter median times on peritoneal dialysis. Identification of infection as a leading cause of hemodialysis transfer and patient and facility factors associated with the risk of hemodialysis transfer can facilitate interventions to reduce these events. Podcast This article contains a podcast at |
| J Am Soc Nephrol |
Sources of Variation in the Carbon Footprint of Hemodialysis Treatment. Similar medical treatments provided in a single geographic region by facilities that are part of the same organization may be expected to have small variations in the determinants of greenhouse gas emissions. However, we found substantial variation in carbon footprints across facilities, treatments, and emission contributors. Understanding the magnitude and variation in greenhouse gas emissions may help identify measures to reduce the environmental impact of hemodialysis treatment. |
| Kidney Int |
Caloric restriction reduces the pro-inflammatory eicosanoid 20- hydroxyeicosatetraenoic acid to protect from acute kidney injury. Interestingly, this effect was accompanied by a partial reversal of caloric restriction-induced changes in protein but not RNA expression pointing towards inflammation, endoplasmic reticulum stress and lipid metabolism. Thus, our findings provide an insight into the mechanisms underlying kidney protection by caloric restriction. Hence, understanding the mediators of preconditioning is an important pre-requisite for moving towards translation to the clinical setting. |
Daprodustat prevents Cyclosporine-A mediated anemia and peritubular capillary loss. Although daprodustat showed only marginal effect on its own, angiogenesis-related pathways were among the most profoundly impacted by daprodustat when given on top of Cyclosporine-A. Additionally, Cyclosporine-A lowered the blood hemoglobin concentration and caused kidney capillary rarefaction, which daprodustat prevented. Thus, combined daprodustat/Cyclosporine-A treatment prevented deleterious Cyclosporine-A effects on microcirculation and hemoglobin, and the protective action of daprodustat involves suppression of broad protein phosphorylation changes caused by Cyclosporine-A. |
Diverse molecular causes of unsolved autosomal dominant tubulointerstitial kidney diseases. However, a small number of families are indeed affected by diseases classically described as a glomerular entity. Thus, incomplete clinical phenotyping and atypical clinical presentation may have led to the classification of ADTKD. The identified novel candidate genes by exome sequencing will require further functional validation. |
Klotho-derived peptide 6 ameliorates diabetic kidney disease by targeting Wnt/ß-catenin signaling. Mutated KP6 with a scrambled amino acid sequence failed to bind Wnts and did not alleviate DKD in db/db mice. Thus, our studies identified KP6 as a novel Klotho-derived peptide that ameliorated DKD by blocking Wnt/ß-catenin. Hence, our findings also suggest a new therapeutic strategy for the treatment of patients with DKD. |
Lineage tracing analysis defines erythropoietin-producing cells as a distinct subpopulation of resident fibroblasts with unique behaviors. During fibrosis caused by ureteral obstruction, Epo CreERT2/+ -labeled cells were found to transdifferentiate into myofibroblasts with concomitant loss of Epo-producing ability, and their numbers and the proportion among resident fibroblasts increased during fibrosis, indicating their high proliferative capacity. Finally, we confirmed that Epo CreERT2/+- labeled cells that lost their Epo-producing ability during fibrosis regained their ability after kidney repair due to relief of the ureteral obstruction. Thus, our analyses have revealed previously unappreciated characteristic behaviors of Epo-producing cells, which had not been clearly distinguished from those of resident fibroblasts. |
Myeloid-derived Growth Factor Deficiency Exacerbates Mitotic Catastrophe of Podocytes in Glomerular Disease. Mechanistically, MYDGF regulates the expression of the transcription factor RUNX2 which mediates part of MYDGF effects. Importantly, a significant reduction of MYDGF was found in glomeruli from patients with glomerular disease due to focal segmental glomerulosclerosis and diabetic kidney disease and the level of MYDGF was correlated with glomerular filtration rate, serum creatinine and podocyte loss. Thus, our studies indicate that MYDGF may be an attractive therapeutic target for glomerular disease. |
Naturally occurring stable calcium isotope ratios are a novel biomarker of bone calcium balance in chronic kidney disease. Isotopically light 42 Ca is preferentially incorporated into bone, while heavier 44 Ca is excreted. The ratio ( 44/42 Ca ratio in patients receiving dialysis was 157% lower than that of age-matched children and 29% lower than levels in elderly women with osteoporosis, implying significantly lower bone mineral content. Thus, calcium isotope ratios may provide a novel, sensitive and non-invasive method of assessing bone calcium balance in chronic kidney disease. |
Oral Coenzyme Q10 supplementation leads to better preservation of kidney function in steroid resistant nephrotic syndrome due to primary Coenzyme Q10 deficiency. CoQ10 supplementation led to significantly better preservation of kidney function (5-year kidney failure-free survival 62% vs 19%) with an improvement in general condition and neurological manifestations. Side effects of treatment were uncommon and mild. Thus, our findings indicate that al patients diagnosed with primary CoQ10 deficiency should receive early and life-long CoQ10 supplementation to decelerate the progression of kidney disease and prevent further damage to other organs. |
Preemptive simultaneous pancreas kidney transplantation has survival benefit to patient. Preemptive transplantation was also associated with significant superior kidney graft survival compared to those on dialysis (death-censored: 84.3% vs 75.4%, respectively; estimated half-life of 38.57 [38.33 -38.81] vs 22.35 [22.17 - 22.53] years, respectively). No differences were observed between both groups neither for pancreas graft survival nor for post-transplant surgical complications. Thus, our results sustain the relevance of early referral for pancreas transplantation and the importance of pancreas allocation priority in reducing patient mortality after simultaneous kidney-pancreas transplantation. |
Results of untargeted analysis using the SOMAscan proteomics platform indicates novel associations of circulating proteins with risk of progression to kidney failure in diabetes. Using multivariable LASSO regression analysis, five proteins (LAYN, ESAM, DLL1, MAPK11 and endostatin) were found independently associated with risk of progression to kidney failure. Thus, our study identified proteins that may be considered as new candidate prognostic biomarkers to predict risk of progression to kidney failure in diabetic kidney disease. Furthermore, three of these proteins (DLL1, ESAM, and MAPK11) were selected as candidate biomarkers when al SOMAscan results were evaluated. |
Ttc21b deficiency attenuates autosomal dominant polycystic kidney disease in a kidney tubular- and maturation-dependent manner. Unlike an IFT-A adaptor, deleting Ttc21b in juvenile ADPKD mice is partially ameliorative. Thus, our studies suggest that different microenvironmental factors, found in distinct nephron segments and in developing versus mature stages, modify ciliary homeostasis and ADPKD pathobiology. Further, elevated levels of O-GlcNAc, which regulates cellular metabolism and ciliogenesis, may be a pathological feature of ADPKD. |
Use of renin angiotensin aldosterone system inhibitors in children with lupus and time to glucocorticoid discontinuation. Among 158 incident nephritis cases, early RAAS inhibitor initiation was significantly associated with a faster rate of glucocorticoid discontinuation (adjusted sub-distribution hazard ratio 1.81, 95% confidence interval [1.09 - 3.00]). Thus, early initiation of RAAS inhibitors may have a role in children newly diagnosed with lupus nephritis; not only those with refractory proteinuria after induction therapy. Hence, integrated health systems data could be leveraged to confirm these findings and optimize adjunctive therapies in pediatric lupus. |
| Nephrol Dial Transplant |
Inhibit progression of coronary artery calcification with vitamin k in hemodialysis patients (the iPACK-HD study): a randomized, placebo-controlled multi-centre, pilot trial. We demonstrated that phylloquinone treatment improves vitamin K status and that a fully powered randomized trial may be feasible. |
Renal denervation in patients with chronic kidney disease: current evidence and future perspectives. A growing body of clinical evidence supports the safety and efficacy of renal denervation in this difficult-to-control population. In addition, preclinical and clinical research indicate potential nephroprotective effects in CKD patients. The current review examines recent research on renal denervation with focus on renal disease and assesses the latest findings and their implications from a nephrologist's perspective. |
The legacy effect of a home walking exercise program in kidney failure patients on dialysis. In dialysis patients the benefits of a 6-months structured walking program outlast the duration of the intervention and postpone the loss of walking performance which naturally occurs in this population but does not affect QoL and the response to the STS test. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Am J Kidney Dis |
| Clin J Am Soc Nephrol |
| J Am Soc Nephrol |
| Nat Rev Nephrol |
Cardiac metabolic remodelling in chronic kidney disease. Uraemic cardiomyopathy is characterized by myriad cardiac metabolic maladaptations, including altered mitochondrial function, changes in myocardial substrate utilization, altered metabolic transporter function and expression, and impaired insulin response and phosphoinositide-3 kinase-AKT signalling, which collectively lead to impaired cardiac energetics. Interestingly, none of the standard treatments used to treat CKD target the metabolism of the uraemic heart directly. An improved understanding of the cardiac metabolic perturbations that occur in CKD might allow the development of novel treatments for uraemic cardiomyopathy. |
Extracellular vesicles in kidney disease. Stem cells are thought to be the most promising source of extracellular vesicles with regenerative activity. Extracellular vesicles are also attractive candidates for drug delivery and various engineering strategies are being investigated to alter their cargo and increase their efficacy. However, rigorous standardization and scalable production strategies will be necessary to enable the clinical application of extracellular vesicles as potential therapeutics. |
| Semin Nephrol |
Emerging Concepts in Managing Malignancy in Kidney Transplant Patients. Cancer remains a significant cause of morbidity and mortality in kidney transplant recipients, due to long-term immunosuppression. Salient issues to consider in decreasing the burden of malignancy among kidney transplant recipients include pretransplant recipient evaluation, post-transplant screening and monitoring, and optimal treatment strategies for the kidney transplant recipients with cancer. In this review, we address cancer incidence and outcomes, approaches to cancer screening and monitoring pretransplant and post-transplant, as well as treatment strategies, immunosuppressive management, and multidisciplinary approaches in the kidney transplant recipients with cancer. |
Glomerular Diseases of the Kidney Allograft: Toward a Precision Medicine Approach. In this review, we focus on the most commonly encountered recurrent and de novo glomerular diseases in the kidney allograft. We address the important advances made in understanding the immunopathology and genetic susceptibility of glomerular diseases in the native kidney and how to benefit from such knowledge to further our knowledge of post-transplant glomerular diseases. Defining genomic and immune predictors for glomerular diseases in the kidney allograft would support novel donor-recipient matching strategies and development of targeted therapies to ultimately improve long-term kidney allograft survival. |
Histocompatibility Assessment in Precision Medicine for Transplantation: Towards a Better Match. However, the extensive polymorphism in the HLA loci renders this impractical. Thus, there is growing interest in determining whether HLA mismatches at the eplet/epitope level better reflects the true disparity between a donor-recipient pair, with the goal of predicting permissible mismatches versus those that should be avoided because they will elicit a strong alloimmune response. Here, we will discuss the available algorithms used to predict immunogenicity/antigenicity of mismatches and prognosticate graft outcomes. |
Novel Biomarkers in Kidney Transplantation. Current diagnostic studies, interrogating the blood or urine, lack the sensitivity and specificity for early detection of rejection. Transplant kidney biopsy remains the gold standard, but is associated with morbidity. Advances in understanding the immunobiology of rejection have led to multiple, novel diagnostic tests facilitating non-invasive, earlier detection of renal allograft rejection. |
The Complement System in the Modern Era of Kidney Transplantation: Mechanisms of Injury and Targeted Therapies. The involvement of the complement system and its activation around the time of kidney transplantation increasingly is recognized as a key player affecting long-term graft survival. In this review, we highlight the important role of the complement system at every stage of the kidney transplantation process. We review potential triggers of complement activation in kidney transplant patients and discuss novel therapeutic agents that can inhibit the complement system. |
Transplantation in the Age of Precision Medicine: The Emerging Field of Treg Therapy. This success in large part is the result of advances in immunosuppression, however, these regimens come with significant costs including opportunistic infections, and in some cases, direct toxicity to the newly transplanted organs. Further advances are needed. Immunosuppression and tolerance based on regulatory T cells provide an attractive alternative because of their ability to target these immunomodulatory functions specifically to the anti-allograft immune response. |
Letters to the editors and authors’ replies
| Am J Kidney Dis |
| Kidney Int |
all remaining publications eg case reports, images of the month, etc…
| Clin J Am Soc Nephrol |
| J Am Soc Nephrol |
| Kidney Int |
| Nat Rev Nephrol |
| Nephrol Dial Transplant |